Evidence map›Paper›PMID 30341135›Full record

ArticleBMJ open2018

Improve hip fracture outcome in the elderly patient (iHOPE): a study protocol for a pragmatic, multicentre randomised controlled trial to test the efficacy of spinal versus general anaesthesia.

Ana Kowark, Christian Adam, Jörg Ahrens, Malek Bajbouj, Cornelius Bollheimer, Matthias Borowski, Richard Dodel, Michael Dolch, Thomas Hachenberg, Dietrich Henzler and 28 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 5 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 5 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Differences in hip fracture care in Europe: a systematic review of recent annual reports of hip fracture registries.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Pooled it
  5. Pooled it
  6. Trial
  7. Article
  8. Perioperative Management of the Geriatric Trauma Patient.Current anesthesiology reports · 2025
    Article
  9. Review
  10. Total intravenous anesthesia for geriatric hip fracture with severe systemic disease.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Observational
  20. Management of Pain Associated with Fractures.Current osteoporosis reports · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors at 20 institutions in 2 countries.

Ana KowarkDepartment of Anaesthesiology, Medical Faculty RWTH Aachen University, Aachen, Germany.
Christian AdamDepartment of Anaesthesiology, Intensive Care and Pain Therapy, Klinikverbund St. Antonius und St. Josef GmbH, Wuppertal, Germany.
Jörg AhrensDepartment of Anaesthesiology and Intensive Care, Medical University Hannover, Hannover, Germany.
Malek BajboujPsychiatry and Affective Neurosciences, Campus Benjamin Franklin, Charité Center Neurology, Neurosurgery and Psychiatry, Berlin, Germany.
Cornelius BollheimerDepartment of Geriatric Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany.
Matthias BorowskiInstitute of Biostatistics and Clinical Research, University of Muenster, Münster, Germany.
Richard DodelDepartment of Geriatrics, University Hospital Essen, Essen, Germany.
Michael DolchDepartment of Anaesthesiology, Ludwig-Maximilian University (LMU) Munich, Munich, Germany.
Thomas HachenbergDepartment of Anaesthesiology and Intensive Care, University Hospital Magdeburg, Magdeburg, Germany.
Dietrich HenzlerDepartment of Anaesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr-University Bochum, Klinikum Herford, Herford, Germany.
Frank HildebrandDepartment of Orthopaedic Trauma Surgery, Medical Faculty RWTH Aachen University, Aachen, Germany.
Ralf-Dieter HilgersDepartment of Medical Statistics, Medical Faculty RWTH Aachen University, Aachen, Germany.
Andreas HoeftDepartment of Anaesthesiology and Operative Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
Susanne IsfortCenter for Translational & Clinical Research Aachen (CTC-A), Medical Faculty RWTH Aachen University, Aachen, Germany.
Peter KienbaumDepartment of Anaesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany.
Mathias KnobeDepartment of Orthopaedic Trauma Surgery, Medical Faculty RWTH Aachen University, Aachen, Germany.
Pascal KnuefermannDepartment of Anaesthesiology, Gemeinschaftskrankenhaus Bonn, Bonn, Germany.
Peter KrankeDepartment of Anaesthesiology, University Hospital Würzburg, Würzburg, Germany.
Rita Laufenberg-FeldmannDepartment of Anaesthesiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Carla NauDepartment of Anaesthesiology and Intensive Care, University Hospital Schleswig-Holstein, Lübeck, Germany.
Mark D NeumanDepartment of Anaesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Cynthia OlotuDepartment of the Geriatric Anaesthesiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Christopher RexDepartment of Anaesthesiology and Intensive Care, Reutlingen Hospital GMBH, Reutlingen, Germany.
Rolf RossaintDepartment of Anaesthesiology, Medical Faculty RWTH Aachen University, Aachen, Germany.
Robert D SandersDepartment of Anesthesiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.
Rene SchmidtDepartment of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty RWTH Aachen University, Stuttgart, Germany.
Frank SchneiderDepartment of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty RWTH Aachen University, Aachen, Germany.
Hartmut SiebertAktionsbündnis Patientensicherheit e.V., Berlin, Germany.
Max SkorningSection Patient Safety, Medical Advisory Service of Social Health Insurance, Essen, Germany.
Claudia SpiesDepartment of Anaesthesiology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Oliver VicentDepartment of Anaesthesiology and Intensive Care, University Hospital Dresden, Dresden, Germany.
Frank WapplerDepartment of Anaesthesiology and Operative Intensive Care, University Witten/Herdecke, Witten/Herdecke, Germany.
Dieter Christian WirtzDepartment of Orthopaedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
Maria WittmannDepartment of Anaesthesiology and Operative Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
Kai ZacharowskiDepartment of Anaesthesiology, Intensive Care and Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany.
Alexander ZarbockDepartment of Anaesthesiology, Intensive Care and Pain Therapy, University Hospital Muenster, Muenster, Germany.
Mark CoburnDepartment of Anaesthesiology, Medical Faculty RWTH Aachen University, Aachen, Germany.
iHOPE study group
RWTH Aachen University · DEUniversity Hospital Bonn · DECharité - Universitätsmedizin Berlin · DEBQS Institut für Qualität und Patientensicherheit (Germany) · DEDüsseldorf University Hospital · DEEssen University Hospital · DEGemeinschaftskrankenhaus Havelhöhe · DEHerford Hospital · DELudwig-Maximilians-Universität München · DEMedizinische Hochschule Hannover · DESt. Josef Krankenhaus · DEUniversitätsklinikum Würzburg · DEUniversity Hospital Carl Gustav Carus · DEUniversity Hospital Frankfurt · DEUniversity Hospital Magdeburg · DEUniversity Hospital Münster · DEUniversity Medical Center Hamburg-Eppendorf · DEUniversity Medical Center of the Johannes Gutenberg University Mainz · DEUniversity of Lübeck · DEUniversity of Münster · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse. METHODS AND ANALYSIS: The iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design. In total, 1032 patients with hip fracture (>65 years) will be randomised in an intended 1:1 allocation ratio to receive spinal anaesthesia (n=516) or general anaesthesia (n=516). Outcome assessment will occur in a blinded manner after hospital discharge and inhospital. The primary endpoint will be assessed by telephone interview and comprises the time to the first occurring event of the binary composite outcome of all-cause mortality or new-onset serious cardiac and pulmonary complications within 30 postoperative days. In-hospital secondary endpoints, assessed via in-person interviews and medical record review, include mortality, perioperative adverse events, delirium, satisfaction, walking independently, length of hospital stay and discharge destination. Telephone interviews will be performed for long-term endpoints (all-cause mortality, independence in walking, chronic pain, ability to return home cognitive function and overall health and disability) at postoperative day 30±3, 180±45 and 365±60. ETHICS AND DISSEMINATION: iHOPE has been approved by the leading Ethics Committee of the Medical Faculty of the RWTH Aachen University on 14 March 2018 (EK 022/18). Approval from all other involved local Ethical Committees was subsequently requested and obtained. Study started in April 2018 with a total recruitment period of 24 months. iHOPE will be disseminated via presentations at national and international scientific meetings or conferences and publication in peer-reviewed international scientific journals. TRIAL REGISTRATION NUMBER: DRKS00013644; Pre-results.

Indexed as

Clinical Trial Protocols as TopicAgedAnesthesia, GeneralAnesthesia, SpinalArthroplasty, Replacement, HipFemaleHip FracturesHumansMaleMiddle AgedMulticenter Studies as TopicPostoperative ComplicationsPostoperative PainPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicResearch Designanaesthesia in orthopaedicsanaestheticsgeriatric medicine

Identifiers

PMID30341135
PMCPMC6196806
OpenAlexW2897752398

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.